Wednesday, April 11, 2012

What I've Been Reading - The Emperor of All Maladies

I hesitated to make this my "vacation read" but since I didn't have anything else in hand that was speaking to me, I took it with me and started reading it on the flight to Louisville. I finished shortly after I got back - it's a big read. It's an excellent, informative, and extremely well-written account of cancer. The first accounts of cancer are so interesting and the early treatments horrifying. Some of the trials and the key characters in the advancement of research and treatment are very interesting.

The author, Siddhartha Mukherjee, is a skilled and compassionate story-teller, which makes this account of the history of cancer and the slow progress of research and treatment actually engrossing and compelling. It sounds as thought it might be a bit dry and technical and I probably wouldn't have tackled this book except that I'd read such positive reviews that emphasized how accessible and well-written the book is.

There were some areas that I got a lost in, such as the latest RNA and DNA research, but nonetheless, I learned a great deal and have already found what I learned helpful in better understanding the steady flow of cancer research that I regularly follow.

More significantly and unexpected for me was how I found myself relating the stories to people I know who have had to face cancer. It was interesting to understand the state of cancer research and treatment at different times. It broke my heart to read the 80's being referred to as "the dark days of chemotherapy". That's when Charles, a friend, had cancer treatments and died at age 23. I remember vividly. I don't know all the details about his cancer - we were very young and I knew nothing about cancer except to be terrified. To my mind Charles had stomach cancer and whether I'm right or not, I recall Charles as having problems with an ulcer in high school. In this book, the author talks about the discovery of H. pylori ... not discovered until after Charles had died ... that surprised the medical world by determining that most ulcers were caused by this bacteria making them treatable with the proper medication. Significantly to my connecting this with Charles is that H. pylori can be pre-cancerous. I didn't know that before reading this book. It makes me wonder if Charles had developed an ulcer AFTER the identification of H. pylori, might he have avoided cancer?

The book explained things that made me better understand the progress of the cancer that took the life of a friend's husband recently. 

During the chapters on smoking and cancer, I thought of my Dad. I better understand the progress of his cancers ... the first one, a cancer of the esophagus and the second one, caused by the radiation he received for the first cancer. This, to me, is the kicker --- that cancer treatments can actually cause cancer. I thought of the many women I know and have known who have fought breast cancer and how treatments for our cancers have progressed and yet we're still not in the clear. I better appreciate how complex cancer is and how determined it is to survive at our cost. Cancer is pretty foxy and there will probably never be a magic bullet kind of cure for it because cancers are all remarkably different and still changing. I'm grateful that some of the women I know have had the benefit of Herceptin without which many women would not have survived.  One of the happy stories in the book is about a woman who had given up - she was considered a lost cause even by her medical team - and had to be begged to join the drug trial for Herceptin. She is still alive today. There are other good stories in the book.

The book deepened my respect and compassion for oncologists and the difficult work of trying to save people from cancer ... the complexities in the effort to find just the right cocktails of poisons for a particular person and a particular cancer. It's not an exact science by any stretch.

While this isn't a book that would have been good for me to read at certain times over the past few years, it was good for me to read now. I better detach emotionally and I'm able to read research and honest information about cancer without getting too emotionally caught up in it with regard to myself. And I'm glad to better understand cancer in general.

I have to say, I shuddered sometimes when I read about cancer research and treatments in the past 20 years ... about recent discoveries that have impacted my own treatment. And I'm very sure that there will be changes to cancer treatment very soon that I will wish had been part of the knowledge base during my time of treatment.

If you're interested in knowing more about cancer and it's history told in a humane and accessible way, this is a good book to read. has several reviews of the book.


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